PCFA's Policy on PSA Testing

Emerging evidence on the benefits and potential harms of testing and subsequent treatment of asymptomatic men for prostate cancer has led many interested parties around the world to revise their guidance on testing using the PSA, or blood, test and Digital Rectal Examination (DRE)123.

Prostate Cancer Foundation of Australia, in partnership with Cancer Council Australia and a multi-disciplinary expert advisory panel comprising urologists, radiation oncologists, pathologists, general practitioners, medical oncologists, epidemiologists, allied health professionals and consumers, have developed the current national evidence-based clinical practice guidelines on PSA testing and early management of test-detected prostate cancer. Published in 2016, these guidelines recommend:

Men should be offered the opportunity to consider and discuss the benefits and harms of PSA testing before making the decision whether or not to be tested.

The harms of PSA testing may outweigh the benefits, particularly for men aged 70 and older.

Men at average risk of prostate cancer who decide to undergo regular testing should be offered PSA testing every 2 years from age 50 to 69.

Men with a family history of prostate cancer who decide to be tested should be offered PSA testing every 2 years from age 40 to 45 to 69, with the starting age depending on the strength of their family history.

Digital rectal examination is not recommended for asymptomatic men as a routine addition to PSA testing in the primary care setting, but remains an important part of specialist assessment.